Takemi Program in International Health
The Takemi Program in International Health seeks to improve health and health systems around the world by welcoming mid-career health professionals and scholars to the Harvard T. H. Chan School of Public Health to conduct path breaking research and develop their leadership skills.
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Advancing Decent Work for All: A Study on Health Disparities
Among Diverse Work Arrangements
and Employment Status, Including Gig Work, in Japan
Mariko Inoue,1,2 Ichiro Kawachi,1 Mariko Nishikitani,3 Shinobu Tsurugano,4 and Eiji Yano 2
1 Harvard T. H. Chan School of Public Health
2 Graduate School of Public Health, Teikyo University
3 Erickson School of Aging Studies, University of Maryland, Baltimore County
4 Center for Health Sciences and Counseling, Kyushu University
Background
- Non-regular employment has increased rapidly. Deregulation and economic downturns have spurred a substantial increase in non-regular workers in Japan.
- Sustainable Development Goals (SDGs) Goal 8.8: Protect labour rights and promote safe and secure working environments for all workers, including those in precarious employment.
What is already known
- A review article showed that non-regular workers exhibit poorer mental health than regular workers.1
- Non-regular workers have limited access to preventive healthcare behaviors.2
What is Gig Work?
The gig-economy is understood to include two forms of work—”crowdwork” and “work on-demand via apps”—to perform short-term or one-time tasks. This represents a significant shift in traditional employment structures.3
“Innovation 4.0”: The fourth industrial innovation provides individuals opportunities to access flexible arrangements and digital platforms of the gig economy, fundamentally changing how work is organized and delivered.
Objectives
To study how non-regular employment associate with the mental health of workers, including gig workers and participants in sharing economies in Japan.
Methods
- Study Design: A cross-sectional study conducted in March 2023
- Data: Administration of an online questionnaire in collaboration with an online survey company
- Participants: Working men and women aged 18–65 years in Japan (N=3,185)
- Employment Status:
- Regular workers (full-time employees with lifelong contracts)
- Non-regular workers (part-time workers, temporary agency workers, and contract workers)
- Self-employed individuals
- Measurement of Mental Health: Kessler Psychological Distress Scale (K6)
- A score of ≥10 indicates higher psychological distress.
- Ethical Consideration: Teikyo University Medical Research Ethics Committee approved this study
*Participants were asked about their experiences with gig work and engagement with digital platforms.
Results
Main Findings
- Regular workers with gig work experience had the highest odds ratio of psychological distress, followed by non-regular workers with gig work experience.
- Within the same employment category, men who engaged in gig work exhibited higher levels of psychological distress than those who did not participate in gig work.
- Self-employed individuals who exclusively engaged in gig work had lower psychological distress than expected.
Sub-Analysis
- Among men, psychological stress levels tended to be higher among those who had lower income and education levels and were employed in manufacturing and primary industries, compared with white-collar workers. Within the same employment category, men who engaged in gig work exhibited higher levels of psychological distress than those who did not participate in gig work.
- Self-employed individuals who exclusively engaged in gig work had lower psychological distress than expected.
Japanese Government Initiatives (2018) Work Style Reform Hatarakikata Kaikaku
- Ensure equal pay and treatment regardless of employment status
- Implement deregulation, allowing for side jobs to enhance flexibility
Japanese Occupational Health System Coverage
- Employees in large companies (workplaces with 50+ workers)
- Employees in small and medium-sized companies
- Self-employed individuals or sole proprietors
Policy Implications
- The rise of gig-work in Japan does not fit well with the current occupational health system and adds pressure on individuals, potentially widening health disparities.
- To ensure that everyone’s health and working conditions are safeguarded, it is essential to reassess health policies, particularly those concerning side gig work for workers, regardless of their employment status.
References
1. Jaydarifard S, Smith SS, Mann D, Rossa KR, Salehi EN, Srinivasan AG, Soleimanloo SS. Precarious employment and associated health and social consequences; a systematic review. Aust N Z J Public Health 2023;47(4):100074.
2. Inoue M, Tsurugano S, Nishikitani M, Yano E. Full-time workers with precarious employment face lower protection for receiving annual health check-ups. Am J Ind Med 2012; 55 :884-92.
3. De Stefano V. The rise of the “just-in-time workforce”: On-demand work, crowdwork and labour protection in the “gig economy. Geneva: International Labour Organization; 2016. Conditions of work and employment series; No. 71.
Grant Support
This work was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number 22K10374
Contact Information:
Mariko Inoue, MPH, PhD
Fellow, Takemi Program in International Health, Harvard T. H. Chan School of Public Health
minoue@hsph.harvard.edu, inoue-ph@med.teikyo-u.ac.jp